Pathogenesis of Airway Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease and Intervention of Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Chronic obstructive pulmonary disease （COPD） is one of the most common chronic diseases of the respiratory system in the clinic. The disease has a long course and is difficult to cure， which seriously threatens human health. Airway mucus hypersecretion （AMH） is an independent risk factor for COPD and has a significant impact on the development and prognosis of the disease. The review finds that the abnormal proliferation of goblet cells and the excessive secretion of mucin are the direct causes of AMH. The pathogenesis of AMH may be closely related to the inhalation of heterogeneous particles， airway inflammation， the imbalance of mucin/water salt ratio， and the regulation of related signaling pathways. Traditional Chinese medicine （TCM） believes that AMH of COPD belongs to the category of lung distension with phlegm-fluid retention syndrome， and the disease is mainly treated from phlegm on the basis of lung distension. This article summarizes the relevant research in the field of TCM in recent years and finds that the single TCM that effectively intervened AMH of COPD is mainly phlegm-resolving TCM， and the main active ingredients of TCM are flavonoids， terpenoids， phenols， and alkaloids. The main TCM compounds are mainly designed to remove heat-phlegm， warmly resolve cold-phlegm， dry dampness to eliminate phlegm， invigorate Qi， promote blood circulation and dispel phlegm， and invigorate lung， spleen， and kidney. Its mechanism of action may be direct inhibition or indirect inhibition of airway epithelial goblet cell metaplasia and mucin expression by inhibiting airway inflammation， regulating aquaporins to correct the imbalance of mucin/water salt ratio， and regulating signaling pathways， so as to reduce mucus oversecretion in COPD. However， there are still some problems. For example， the research mainly focuses on TCM compounds instead of the single TCM or its effective components. The research on the mechanism of action is not thorough enough， and the research results are not interoperable. The clinical transformation rate of basic research is insufficient. This article systematically reviews the research status of AMH in the treatment of COPD with TCM and puts forward some thoughts on the existing problems， so as to provide a reference for clinical rational medication and in-depth research.

O hormônio antimulleriano e a reserva ovariana: uma revisão integrativa da literatura / The anti-mullerian hormone and the ovarian reserve: an integrative literature review

O hormônio antimulleriano é secretado pelas células da granulosa dos folículos que estão em desenvolvimento no ovário. Por meio da sua dosagem, é possível avaliar a reserva ovariana. A mulher tem seu número máximo de oócitos no perío- do fetal, mas, conforme o tempo passa, existe uma queda do número de células germinativas. Desse modo, para mulheres que têm o desejo de engravidar, a dosa- gem de hormônios e a avaliação da reserva ovariana podem ajudar no processo. O objetivo do estudo foi encontrar evidências na literatura que comprovem que o hormônio antimulleriano é o melhor marcador da reserva ovariana. Para isso, foi realizada uma revisão integrativa, classificada como qualitativa; a busca de da- dos foi realizada no PubMed, utilizando a seguinte palavra-chave: "hormônio anti- mulleriano (HAM)". Foram encontrados oito artigos que abordavam diretamente o tema, e há evidências que corroboram a hipótese de que o hormônio antimulleria- no é um bom marcador da reserva ovariana, sendo necessários mais estudos para determinar a sua superioridade.

The anti-mullerian hormone is secreted by the granulosa cells of follicles that are developing in the ovary. Though its dosage is possible to evaluate the ovarian re- serve. Women have their maximum number of oocytes in the fetal period, but there is a decrease in the number of germinative cells as time goes by. Thus, women that desire to get pregnant can have hormones dosed and the ovarian reserve evalua- ted to help them with this process. The objective of this study was to find evidence in the literature that proves that the anti-mullerian hormone is the best marker of ovarian reserve. For this purpose, an integrative review was conducted, using the key word: "anti-mullerian hormone (AMH)". Eight articles were found on the subject and there is evidence that proves the hypothesis of the anti-mullerian hormone as a good marker, however more studies are needed to determine its superiority.

Clinical and Laboratory Characteristics of Infertile Women with Premature Ovarian Insufficiency

Background: Premature ovarian insufficiency (POI) is the preferred term for the condition that was previously referred to as premature menopause or premature ovarian failure. The condition differs from menopause in that there are varying and residual ovarian functions. This study aimed to analyze the clinical characteristics of infertile women with premature ovarian insufficiency. Material & Methods: This prospective study was conducted at the OPD of Impulse Fertility Center, Impulse Hospital, Dhaka, Bangladesh. The study was conducted for a period from January 2022 to December 2022. A total of 23 patients who received outdoor treatment during the study period were purposively selected as sample size. A purposive sampling technique was followed in this study. After approval by the Ethics committee of the Hospital, informed consent from the respondents was obtained after explaining the purpose of the study to them. To be included in the study, respondents should have met the classical definition of infertility defined by the WHO as the inability of a sexually active non-contraceptive using woman to have a live birth after 12 or more months of regular sexual intercourse without a malefactor. Women who had male-factor infertility were excluded. In this study live birth was used as a measure of proven fertility (Because couples desire children, not simply pregnancies, infertility affects couples regardless of whether the etiology lies in conception or the progression of the pregnancy). All the necessary laboratory investigations were done. A questionnaire was developed and data were collected by interviewing the patients and some data were collected from the laboratory results. Data were processed and analyzed by SPSS 19 version. Results: All patients had normal puberty, and menarche occurred at ages 11–15, followed by a regular menstrual cycle. Women who presented with oligomenorrhea were younger than patients with infertility. The mean period of oligomenorrhea before diagnosis was 0.9 years in the oligomenorrhea group and 1.8 years in the infertility group. The mean age when the infrequent periods started was 28 years in the group with oligomenorrhea and 29 years in the group with infertility, and their anthropometric characteristics were not different. In most patients, the FSH levels on day 3 of their menstrual cycle were less than 25?mU/ml. FSH levels >25?mU/ml were confirmed in two patients with oligomenorrhea and five patients in the infertility group. AMH levels were low than 1.0?ng/ml (considered to be in poor ovarian reserve ranges: from 0.13 to 1.0?ng/ml in patients with oligomenorrhea and from 0.13 to 0.9?ng/ml in the infertility group. Transvaginal ultrasound-determined AFC on menstrual cycle days 4–8 was accessed in all patients. We consider AFC?<?6 small follicles (diameters 3–9?mm) as a low ovarian reserve indicator. The lowest AFC (one small follicle) was noted in one infertile patient with oligomenorrhea. Conclusion: This study concluded that the subjects usually present with menstrual irregularity (oligomenorrhea) or infertility, and after proper evaluation, their poor ovarian reserve can be confirmed and an occult form of POI established. women who presented with only oligomenorrhea were younger than infertile patients; therefore, menstrual irregularity may be the earliest clinical symptom of occult POI.

Exploration of Mechanism of Xiaonang Tiaojing Decoction in Treating PCOS-IR Model Rats Based on AMH/AMHR ⅡSignaling Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the mechanism of Xiaonang Tiaojing decoction（XNTJD）in improving polycystic ovary syndrome with insulin resistance（PCOS-IR）model rats based on anti-Müllerian hormone（AMH）/AMH type Ⅱ receptor（AMHRⅡ）signaling pathway. MethodForty-eight adult female SD rats were randomly divided into the blank group， model group， XNTJD group（11.4 g·kg-1·d-1） and Diane-35 group（0.21 g·kg-1·d-1）， PCOS-IR model was established by high-fat and high-sugar diet combined with letrozole in rats of all groups except the blank group， rats in the administration groups were given the corresponding dose of drugs by gavage for 15 days with an interval of 1 d every 4 d， normal saline of the same volume was given to the blank group and the model group. Estrous cycle was recorded daily during treatment. At the end of treatment， body weight and Lee's index were recorded， AMH， luteinizing hormone（LH）， LH/follicle stimulating hormone（FSH）， testosterone（T）and estradiol（E2）levels were measured by enzyme-linked immunosorbent assay（ELISA）， fasting plasma glucose（FPG）was measured by glucometer， fasting insulin（FINS） level was measured by radioimmunoassay（RIA）， and the insulin resistance index（HOMA-IR） and insulin sensitivity index（QUICKI）were calculated， triglyceride（TG）and total cholesterol（TC）levels were measured by automatic biochemical analyzer， hematoxylin-eosin（HE）staining was used to observe the morphological changes of the ovary， the levels of AMHRⅡ， bone morphogenetic protein-15（BMP-15）and Smad5 in ovarian tissues were detected by immunohistochemistry（IHC），Western blot was used to analyze the protein expression levels of AMHRⅡ， BMP-15 and Smad5. ResultCompared with the blank group， a large number of leukocytes were observed in the vaginal exfoliated cells of rats in the model group， mainly in diestrus， the levels of body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）were significantly increased（P<0.01）， and QUICKI and E2 levels were significantly decreased（P<0.01）， there were more cystic bulges on the ovarian surface， more wet weight， more atretic and cystic dilated follicles in the ovarian tissues， and the thickness of granulosa cell layer was reduced without oocytes， the expression level of AMHRⅡ protein in ovarian tissues was significantly increased（P<0.01）， and the expression levels of BMP-15 and Smad5 proteins were significantly decreased（P<0.01）. Compared with the model group， the exfoliated cells in the vagina of rats treated with XNTJD group showed keratinocytes from the 5th to 6th day of treatment， and a stable estrous cycle gradually appeared， body weight， Lee's index， glucose-lipid metabolism indexes（FPG， FINS， HOMA-IR， TG， TC）， AMH and sex hormones（LH， LH/FSH， T）levels were significantly decreased（P<0.05， P<0.01）， QUICKI and E2 levels were significantly increased（P<0.01）， ovarian surface was smoother and lighter in wet weight， oocytes and mature follicles were observed in ovarian tissues， the thickness of granulosa cell layer increased and the morphology was intact， the expression levels of BMP-15 and Smad5 proteins were significantly increased（P<0.01）and the expression level of AMHRⅡ protein was significantly decreased（P<0.01）in ovarian tissues. ConclusionXNTJD may mediate the up-regulation of BMP-15 and Smad5 in ovarian tissues of PCOS-IR rats by down-regulating AMH/AMHRⅡ， thereby improving ovarian function， sex hormones and glucose-lipid metabolism levels in PCOS-IR rats.

Correlation analysis of vitamin D level and anti-Müllerian hormone in infertile female and the role in predicting pregnancy outcome / 北京大学学报(医学版)

OBJECTIVE@#To investigate the relationship between serum 25(OH)D and anti-Müllerian hormone (AMH) among infertile females and their predictive impacts on in vitro fertilization and embryo transfer pregnancy outcome.@*METHODS@#Totally 756 infertile females treated with assisted reproductive technology were enrolled and divided into three groups according to their vitamin D levels (group A with serum 25(OH)D≤10 μg/L, group B with serum (10-20) μg/L, and group C with serum ≥20 μg/L). The serum AMH levels were detected. The differences among the groups were analyzed, as well as the correlation between vitamin D levels and serum AMH levels in various infertility types (fallopian tube/male factor, polycystic ovary syndrome (PCOS), ovulation disorders excluded PCOS, endometriosis, unexplained infertility, and others). Also, the predictive roles of vitamin D and AMH in pregnancy outcome in all the infertile females were discussed.@*RESULTS@#(1) 87.7% of the enrolled females were insufficient or deficient in vitamin D. (2) The serum AMH levels in the three groups with different vitamin D levels were 1.960 (1.155, 3.655) μg/L, 2.455 (1.370, 4.403) μg/L, 2.360 (1.430, 4.780) μg/L and there was no significant difference in serum AMH levels among the three groups (P>0.05). (3) Serum 25(OH)D and AMH levels presented seasonal variations (P < 0.05). (4) There was no prominent correlation between the serum AMH level and serum 25(OH)D level in females of various infertility types after adjusting potential confounding factors [age, body mass index (BMI), antral follicle count (AFC), vitamin D blood collection season, etc.] by multiple linear regression analysis (P>0.05). (5) After adjusting for confounding factors, such as age, BMI, number of transplanted embryos and AFC, the results of binary Logistics regression model showed that in all the infertile females, the serum AMH level was an independent predictor of biochemical pregnancy outcome (P < 0.05) while the serum 25(OH)D level might not act as a prediction factor alone (P>0.05). In the meanwhile, the serum 25(OH)D level and serum AMH level were synergistic predictors of biochemical or clinical pregnancy outcome (P < 0.05).@*CONCLUSION@#Based on the current diagnostic criteria, most infertile females had vitamin D insufficiency or deficiency, but there was not significant correlation between serum 25(OH)D and ovarian reserve. While vitamin D could not be used as an independent predictor of pregnancy outcome in infertile females, the serum AMH level could predict biochemical pregnancy outcome independently or jointly with vitamin D.

Leydig and Sertoli cell function in individuals with genital ambiguity, 46,XY karyotype, palpable gonads and normal testosterone secretion: a case-control study

Abstract BACKGROUND: Because normal male sexual differentiation is more complex than normal female sexual differentiation, there are more cases of disorders of sex development (DSDs) with 46,XY karyotype that have unclear etiology. However, Leydig and Sertoli cell markers are rarely used in distinguishing such individuals. OBJECTIVES: To evaluate the function of Leydig and Sertoli cells in individuals with genital ambiguity, 46,XY karyotype, palpable gonads and normal testosterone secretion. STUDY DESIGN AND SETTING: Case-control study with 77 patients, including eight with partial androgen insensitivity syndrome, eight with 5α-reductase deficiency type 2 (5ARD2) and 19 with idiopathic 46,XY DSD, and 42 healthy controls, from the Interdisciplinary Study Group for Sex Determination and Differentiation (GIEDDS), at the State University of Campinas (UNICAMP), Campinas, Brazil. METHODS: Baseline levels of gonadotropins, anti-Müllerian hormone (AMH), inhibin B, insulin-like 3 (INSL3), testosterone and dihydrotestosterone in cases, and AMH, inhibin B, and INSL3 levels in controls, were assessed. RESULTS: There was no significant difference in age between cases and controls (P = 0.595). AMH and inhibin B levels were significantly lower in cases than in controls (P = 0.031 and P < 0.001, respectively). INSL3 levels were significantly higher in cases than in controls (P = 0.003). Inhibin B levels were lower in 5ARD2 patients (P = 0.045) and idiopathic patients (P = 0.001), in separate comparisons with the controls. CONCLUSION: According to our findings, we can speculate that inhibin B levels may be used to differentiate among DSD cases.

Surgical management and molecular diagnosis of persistent Müllerian duct syndrome in Chinese patients / 亚洲男科学杂志(英文版)

Persistent Müllerian duct syndrome (PMDS) is a rare clinically and genetically overlapping disorder caused by mutations in the anti-Müllerian hormone (AMH) gene or the anti-Müllerian hormone receptor type 2 (AMHR2) gene. Affected individuals present uterus and tubes in normally virilized males and are discovered unexpectedly during other surgeries. Since it is rare and complex, a definitive clinical diagnosis can be missed, and there are no guidelines regarding how to deal with the uterus. In the present study, exome sequencing and Sanger verification were performed for causal variants in 12 PMDS patients. Preoperative diagnoses were made by positive exome sequencing in 8 patients. Of them, 7 patients evoked on the basis of ultrasound indicating bilateral testes on the same side of the body. Twelve different AMH variants (2 frameshift/nonsense, 1 deletion, 8 missense, and 1 in-frame) in 9 patients and 6 different AMHR2 variants (5 missense and 1 splicing) in 3 patients were identified. Seven variants were classified as "pathogenic" or "likely pathogenic", and 4 of them were novel. All but two patients with AMH defects showed low serum AMH concentrations, but all patients with AMHR2 defects showed elevated AMH levels. During surgery, an abnormal vas deferens was observed in half of the patients. Eight patients underwent orchidopexy with uterine preservation. Of them, 2 patients presented complications including irreducible cryptorchidism, and 3 patients developed Müllerian remnant cysts. Three patients underwent subtotal hysterectomy. Of them, one patient had complication of injury to the vas deferens, and one had hemorrhage after operation. This is the first report of PMDS involving a large Chinese population. The present study not only expands the variation spectrum but also provides clinical experience about the management of the uterus.

Study of incidence of premature ovarian failure in patient attending outpatient department for infertility in a tertiary care centre

Background: To assess the incidence of premature ovarian failure in cases attending infertility outpatient Department of Obstetrics and Gynecology in a tertiary care centre. A total of 350 patients attending infertility opd were screened over period of 150 days from which authors observed premature menopause in 10 cases accounting for an incidence of 2.8%. POF affects approximately one in 10,000 women by age 20; one in 1,000 women by age 30; one in 100 women by age 40.  Premature ovarian failure is a common cause of infertility in women.Methods: Patient attending outpatient Department of Obstetrics and Gynecology with age less than 40 years and infertility, symptoms of menopause were enrolled for the study for duration of 150 days.Results: Present study authors found a total of 2.8% of patient presenting in our outpatient department for infertility had Premature ovarian failure.80% of them were symptomatic suffering with symptoms of hormonal deficiencies .100% of patient with infertility diagnosed as premature ovarian failure had low AMH and High FSH and LH levels indicating poor prognosis.Conclusions: Patient presenting with infertility and amenorrhoea can be cases of premature menopause. Here it is essential to investigate and treat the patient. Infertility might be one of the early presenting symptoms if not the first one. These patients if treated and diagnosed early can have a better living. Considering the wide spectrum of functional derangements in patient with early menopause and benefits of early hormone replacements these patients should be diagnosed and treated early.

Diferencias en los polimorfismos de genes asociados al control del desarrollo folicular entre búfalos (Bubalus bubalis) y vacunos (Bos indicus) / Differences in polymorphisms of genes associated with follicle development control between buffaloes (Bubalus bubalis) and cattle (Bos indicus) / Diferenças nos polimorfismos genéticos associados ao controle do desenvolvimento folicular entre búfalos (Bubalus bubalis) e bovinos (Bos indicus)

Resumen Se han encontrado asociaciones entre polimorfismos genéticos y parámetros reproductivos, este abordaje adicionalmente permitiría proponer explicaciones a diferentes fenómenos estudiados. FSHr, InhA, AMH y AMHr son genes asociados al desarrollo folicular, que tienen una alta homología y la misma función en bovinos. El objetivo del presente trabajo fue evaluar en bovinos muy relacionados si se encuentran algunos polimorfismos asociados a parámetros reproductivos reportados en otras especies. Durante el 2018, en el Magdalena Medio Colombiano fueron tomadas muestras de sangre anticoagulada de 50 búfalas mestizas (Bubalus bubalis) y 50 vacas cebú comercial (Bos indicus). Se registró la paridad, días abiertos, intervalo parto primer servicio y edad al primer parto de cada animal, sin alteraciones anatómicas, con edad y peso similar, mantenidos en las mismas condiciones de alimentación y manejo. Se extrajo el ADN por el método de Salting out y se evaluaron los polimorfismos de acuerdo con lo reportado en la literatura. Se compararon los datos usando la prueba Mann Whitney, se consideró significativo un valor de p<0,05. Se encontró que los búfalos tienen menores niveles de AMH, edad al primer parto, intervalo ente partos que las vacas (p<0,001), mayor paridad (p=0,005). No se confirmaron los po- limorfismos reportados en Holstein y en humanos en ninguna de las muestras y especies analizadas. No confirmar los hallazgos en bovinos de otras razas y espe- cies, aunque las especies tengan diferentes parámetros reproductivos, muestra la necesidad de replantear el abordaje del estudio de la asociación de los fenómenos reproductivos y genéticos.

Abstract Associations have been found between genetic polymorphisms and reproductive parameters, this approach additionally would allow us to propose explanations to the phenomena studied. FSHr, InhA, AMH and AMHr are genes associated with follicular development, which have a high homology and the same function in bovines. The objective of this work was to evaluate if some polymorphisms described in other species associated with reproductive parameters are found in two closely related bovines. During 2018, in the Colombian Magdalena Medio anticoagulated blood samples from 50 buffaloes (Bubalus bubalis) and 50 commercial zebu cows (Bos indicus) were taken. All animals without anatomical abnormalities and similar weight and age were taken and the. parity, intercalving period and age at first calving were also recorded. DNA were extracted using Salting out method and the reported polymorphisms of the above mentioned genes were evaluated. Data were compared using Mann Whitney test and p<0.05 value were considered significant. Buffaloes have lower AMH levels, age at first calving, calving interval than Bos indicus cows (p<0.001) and higher parity (p=0.005). The polymorphisms reported in Holstein and humans were not confirmed in any of the samples and species analyzed. The results, are in some way paradoxical because there are differences in reproductive parameters but nothing different in the studies genes. It shows the need to rethink the approach of the study of the association of reproductive and genetic phenomena

Resumo Foram encontradas associações entre polimorfismos genéticos e parâmetros repro- dutivos; essa abordagem também permitiria propor explicações para os diferentes fenômenos estudados. FSHr, InhA, AMH e AMHr são genes associados ao desenvol- vimento folicular, que apresentam alta homologia e a mesma função em bovinos. O objetivo do presente trabalho foi avaliar em bovinos intimamente relacionados se alguns polimorfismos associados a parâmetros reprodutivos relatados em outras espécies. Em 2018, 50 vacas de búfalo (Bubalus bubalis) e 50 de zebu comerciais (Bos indicus) foram amostradas na Magdalena Medio colombiana. Foram registra- das paridade, dias abertos, intervalo de nascimento do primeiro serviço e idade no primeiro nascimento de cada animal, sem alterações anatômicas, com idade e peso semelhantes, mantidas nas mesmas condições de alimentação e manuseio. O DNA foi extraído pelo método Salting out e os polimorfismos foram avaliados de acordo com o relatado na literatura. Os dados foram comparados pelo teste de Mann Whitney, sendo considerado significativo um valor de p <0,05. Verificou-se que os búfalos apresentam níveis mais baixos de AMH, idade do primeiro nascimento, intervalo entre os nascimentos que as vacas (p <0,001), maior paridade (p = 0,005). Os polimorfis- mos relatados em Holstein e em humanos não foram confirmados em nenhuma das amostras e espécies analisadas. A não confirmação dos achados em bovinos de outras raças e espécies, embora as espécies possuam diferentes parâmetros repro- dutivos, mostra a necessidade de repensar a abordagem do estudo da associação dos fenômenos reprodutivos e genéticos.

Afectación de la función testicular en niños con criptorquidia / Testicular dysfuntion in boys with cryptorchidism

Introducción: La capacidad funcional del testículo en los niños con criptorquidia ha recibido poca atención. La hormona anti-mülleriana (AMH), producida por la célula de Sertoli, es el marcador ideal para evaluar la función testicular durante la infancia. Objetivo: Caracterizar la función testicular en niños prepuberales antes de la orquidopexia. Investigar la asociación entre función testicular y las características de la criptorquidia. Pacientes y métodos: Estudio de corte transversal y analítico, retrospectivo. Medida de resultado principal: concentración de AMH. Medidas de resultados secundarias: concentraciones de gonadotrofinas y testosterona. Para comparación, se utilizaron los niveles hormonales de 179 niños normales. Resultados: Se seleccionaron 186 pacientes con criptorquidia bilateral y 124 con criptorquidia unilateral. La mediana de SDS de AMH fue menor a 0 en ambos grupos. La concentración sérica de AMH fue más baja en pacientes con criptorquidia bilateral que en niños controles y en niños con criptorquidia unilateral. La testosterona estuvo disminuida en niños menores de 6 meses. Las gonadotrofinas estuvieron aumentadas en un bajo porcentaje de los casos. Conclusión: Los niños prepuberales con criptorquidia, especialmente aquellos con criptorquidia bilateral, tienen menor producción de AMH y una considerable prevalencia de disfunción testicular

Introduction: Little information is available on testicular function in boys with cryptorchidism. Anti-müllerian hormone (AMH) is a good marker of testicular functionin childhood. Objective: the aim of this study was to assess testicular function in boys with cryptorchidism before orchiopexy, and to look for an association between testicular function and features of cryptorchidism. Patients and methods: We performed a cross-sectional, retrospective study. Main outcome measure was serum AMH concentration, and secondary variables were gonadotropin and testosterone concentrations. For comparison, levels in 179 normal boys were compared. Results: 186 boys with bilateral cryptorchidism and 124 with unilateral cryptorchidism were included. Mean SDS AMH was below 0 in both groups. Mean serum AMH was lower in boys with bilateral cryptorchidism, as compared to unilateral cryptorchidism and controls between 6 months and 8.9 years of age. Testosterone was lower than normal in boys < 6 months of age. Gonadotropins were rarely affected. Conclusions: Prepubertal boys with cryptorchidism, especially those with bilateral forms, have a lower AMH production, reflecting testicular dysfunction

Advances in research on anti-Müllerian tube hormone and male reproductive endocrine-related diseases / 基础医学与临床

Anti-Müllerian tube hormone(AMH), also known as Müllerian inhibitory substances, is a member of the transformation system. In males, AMH is secreted by immature Sertoli cell which promotes the degradation of male fetal Müllerian tubes,and participates in testicular development and spermatogenesis.AMH can regulate gona-dotropin-releasing hormone (GnRH), pituitary secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH),testicular stromal cells secrete testosterone(T) and inhibin B causes male reproductive endocrine related diseases through HPG axis.

AMH in Osteoporosis: Correlation with Bone Biochemical Markers and Estrogen / 现代检验医学杂志

Objective To assess the serum level of anti-Mullerian hormone (AMH) in premenopausal women with osteoporosis and its correlation with bone biochemical markers and estrogen (E2).Methods From December 2014 to March 2016,159 subjects of premenopausal women in the osteoporosis outpatient clinic of Xi'an Honghui Hospital were selected.According to the bone mineral density (BMD),the patients were divided into osteoporosis group (43 cases),osteopenia group (56 cases),bone mass normal group (60 cases).AMH,E2,TPINP,OC,β-CTX,25(OH)D and PTH were measured by automatic electrochemiluminescence immunoassay system (ECLIA).T-test and Pearson correlation analysis were used to describe the statistics.The date with statistical significance were analyzed by receiver operating characteristic(ROC) curve.Results The serum AMH level in osteoporosis and osteopenia groups were respectively lower than the normal group (t=-6.183～-0.956,P=0.000～0.040).The TPINP,OC,β-CTX and PTH in osteoporosis were much higher than the normal group (t=3.159 ～ 5.973,P=0.000 ～ 0.010),all of them was a statistical significance.The 25 (OH)D had no statistical significance between the three groups (t=-0.938～-0.469,P=0.351～0.640).The serum AMH level of three groups firstly increased (20～25) and then decreased (＞25) with age increasing.AMH was positively correlated with BMD (r=0.422,P=0.000),but negatively correlated with TPINP (r=-0.184,P =0.020),β-CTX (r=-0.173,P=0.030),OC (r=-0.238,P=0.003).There were no correlation with E2 (r=0.150,P=0.059),25(OH)D (r=0.036,P=0.652),PTH (r=-0.140,P=0.078).The area under the ROC curve was 0.728.Conclusion The serum AMH level was a better parameter for predicting low bone mass.

Effect of bushenyangxue prescription on the levels of anti-mullerian hormone in rat with premature ovarian failure / 中国比较医学杂志

Objective Establish premature ovarian failure ( POF ) model in female Sprague Dawley by tripterygium wilfordii , and investigate the effect of bushenyangxue prescription on the levels of anti -mullerian hormone ( AMH) .Methods After POF model was established , rats were gave by gavage of different dosage of Bushenyangxue prescription for 30 days.The changes of histomorphology on rat ovarian tissue were observed by hematoxylin -eosin staining. Serum AMH concentraction , protein and mRNA expression of AMH were measure with ELISA , immunohistochemical staining and qRT-PCR, respectively .Results The follicle and corpus luteum were atrophied after tripterygium wilfordii challenge, which was improved after treatment with Bushenyangxue prescription .Serum AMH, protein and mRNA expression of AMH were decreased tripterygium wilfordii-treated rats; this decrease was inhibited after treatment with Bushenyangxue prescription .Conclusions Our study indicates that Bushenyangxue prescription could preserve the AMH levels of POF rats.These findings suggest that Bushenyangxue prescription may be a useful strategy to treat POF .

Anti-mullerian hormone in seminal plasma and serum:association with sperm parameters / 国际检验医学杂志

Objective To explore the association of anti-mullerian hormone(AMH)in seminal plasma and serum with sperm counts and energy for male.Methods For 215 cases of healthy male selected from our reproductive clinic,with women′s reason for infertility,seminal plasma and serum AMH were detected,as semen parameters(sperm density,living rate,vitality and malformation rate),6 items of serum sex hormone.In seminal plasma and serum AMH respectively as the dependent variable,using multiple line-ar regression model to explore its quantitative relation with semen parameters and sex hormone levels.Results 215 cases were en-rolled,aged 34.28±5.70 years,while the median of the seminal plasma AMH was 0.47,quartile 0.05-3.09 pmol/ejaculation.The median of the serum AMH was 53.07,quartile 32.32 -72.20 pmol/L.Through multiple linear regression analysis,after adjusted by age and BMI,the seminal plasma of AMH and total number of sperm,sperm concentration,dynamic motility,total sperm activi-ty,serum inhibin B were positively correlated(P 0.05);Serum AMH negatively correlated with serum FSH,with serum inhibin B positively(P 0.05).Conclu-sion The seminal plasma of AMH were positively correlated with sperm concentration,sperm counts,sperm vitality,with the asso-ciation for serum AMH not yet found.

Reference Values for the Revised Anti-Müllerian Hormone Generation II Assay: Infertile Population-based Study

Anti-Müllerian hormone (AMH) is now accepted as an important clinical marker of ovarian reserve and is increasingly measured as an initial evaluation at infertility clinics. The aim of this study was to establish reference values for the revised second generation (Gen II) assay using population-based data. In this population-based cohort study, AMH data from unselected infertile women aged 25–45 years from June 2013 to June 2014 (n = 15,801) were collected. The AMH values were measured using the revised Gen II assay. We established and validated 5 AMH-age regression models. Based on the optimal AMH-age model, reference values and centile charts were obtained. The quadratic model (log AMH = 0.410 × age − 0.008 × age²− 3.791) was the most appropriate for describing the age-dependent decrease in AMH measured using the revised Gen II assay. This is the largest population-based study to establish age-specific reference values of AMH using the revised Gen II assay. These reference values may provide more specific information regarding the ovarian reserve estimation of infertile women.

Effects of moxibustion at Shenshu (BL 23) on level of sex hormones and AMH in sub-health peri-menopausal women / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects between moxibustion at Shenshu (BL 23) and oral administration of Vitamin E on quality of life and mechanism in sub-health perimenopausal women, aiming to provide clinical evidence of moxibustion for health care of sub-health female.</p><p><b>METHODS</b>Sixty participants were randomly divided into a moxibustion group and a medication group, 30 cases in each one. The volunteers in the moxibustion group were treated with mild moxibustion at bilateral Shenshu (BL 23) for 15 min, once a day; five treatments were considered as a course of treatment, and totally 4 courses were given with an interval of 2 days between courses. The volunteers in the medication group were treated with oral administration of soft capsule of Vitamin E, once a day, continuously for 28 days. The scores of quality of life and serum levels of sex hormones, anti-Mullerian hormone (AMH) and inhibin B (INHB) were measured before and after treatment in the two groups.</p><p><b>RESULTS</b>① Compared before treatment, the scores of quality of life in the two groups were both significantly increased after treatment (both<0.01), which was more superior in the moxibustion group (<0.05). ② Compared before treatment, the serum levels of estradiol (E) and progesterone in the moxibustion group were significantly increased after treatment, especially for premenopausal volunteers (both<0.01). ③ After moxibustion, the serum level of AMH was significantly improved (<0.01), however, the effect on INHB had no statistical difference (>0.05).</p><p><b>CONCLUSIONS</b>Moxibustion could effectively improve the quality of life in sub-health perimenopausal women, regulate the levels of sex hormones and AMH, improve ovarian reserve function, and delay ovarian aging.</p>

Effect of Bushencupailuan Decoction on ovarian morphology and sex hormone levels in rat models of polycystic ovary syndrome / 中国比较医学杂志

Objective To explore the effect of Bushencupailuan decoction , a Chinese medicine formula , on polycystic ovary syndrome ( PCOS ) and its mechanism through observing the sex hormones , anti-Müllerian hormone ( AMH) and the morphology of ovaries of PCOS rat models .Methods Bushencupailuan decoction was administered in DHEA-induced PCOS model rats .The pathology of ovaries was examined , and the serum sex hormones and AMH were detected.Results Compared with the normal group , the ovaries of model group rats had severe diffuse cystic dilatation and cystic cavities of different sizes .The granular layer cells were compressed into flat or cubical shapes .Corpora lutea and follicles in various stages of development were rare .Bushencupailuan decoction obviously improved the numbers of mature follicles and corpora lutea , levels of sex hormones and AMH of PCOS model rats compared with those of model rats ( P<0.05).Conclusions Bushencupailuan decoction can treat PCOS by improving the serum sex hormone levels in PCOS model rats, reduce serum AMH and help to restore ovulation .

Value of Testing Serum Testosterone and AMH in the Diagnosis of Female Infertility / 现代检验医学杂志

Objective To study the application of androgens,AMH for female infertility diagnosis value.Methods Used chemiluminescence to detect androgen testosterone (To),androstenedione (AND),17 (HS)To hydrogen sulfate therapy (17HS),sex hormone binding globulin (SHG)and resistance To seedling le’s hormone (anti-Mullerian hormone,AMH)of 258 cases of patients with female infertility.According to the reason of infertility,female infertility patients were divided into observation group (158 cases of endocrine infertility)and control group (100 cases of tubal factor infertility)and two groups of data had statistical analysis with t test.Used Pearman’s correlation method to analyse the relationship between serum AMH level and AND,SHG in patients wirh female infertility.and used ROC curve to evaluate efficiency of AND and AMH to the diagnosis of female infertility.Results ①The indicators To observation group AND control group,AND,AMH and SHG were (1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml and (64.2±32.1 vs 89.3±30.2)nmol/L,respectively.Compared with the control group,observation group To,AND and AMH were significantly higher than the control group (t=13.02,11.36,9.35,P values<0.01),but SHG was significantly low-wer than thecontrol group(t=7.35,P<0.01).②Between the biology to produce ets (AMH:7.63~10.1 ng/ml,AND:0.3~3.3 ng/ml,17 HS:18~144μg/dl,SHG:80~560 nmol/L)as the standard,in the observation group:17 HS increased 17.7%,AND increased 72.2%,AMH increased 87.9% and SHG 51.2% reduction.③AMH level and the AND existed positive correlation (r=0.579,P<0.05),negatively correlated with SHG (r=0.763,P<0.05).④AMH,AND and SHG diagnosis of infertility area under the ROC curve (AUC),were 0.921,0.863 and 0.736 respectively,best cutoff value were11.26 ng/ml,4.62 nmol/L and 32.62 ng/ml respectively,and sensitivity of 89.7%,72.9% and 59.6%.Specific degrees were 86.2%,86.2% and 75.6% respectively,and accuracy of 87.1%,87.1% and 81.6%.Jointed inspection of AND,AMH and SHG in the diagnosis of infertility,the sensitivity of the specific degree were 96.3% and 90.2% respectively.Conclusion It showed that AMH,AND and SHG have diagnostic value of internal secretory infertility with ROC curve analysis.De-tection of combined AMH,AND and SHG is more meaningful to the early diagnosis and treatment of infertility.

Correlation of Age and Antimullerian Hormone in Assisted Reproductive Technology Program Outcome.

Abstract : Increasing female literacy and employment have resulted in a clear rise in the age at which women conceive. As fertility starts to decline with advancing age more and more number of women are facing the problem of infertility and are seeking medical attention to over come this problem. This resulted in more number of women seeking medical help to over come the problem of Infertility. This age related decline in ovarian reserve is not uniform in all women of reproductive age. A number of ovarian reserve tests were developed to overcome this problem. But to date there is no ideal marker for predicting ovarian reserve and pregnancy outcome in assisted reproductive technology program (ART). Recent studies indicate that anti mullein hormone is a promising marker for predicting ovarian reserve and pregnancy out come. The aim of this study was to assess the influence of age on Anti-Mullerian Hormone (AMH) in ART program outcomes. Ninety-three subjects in the age group of 25 to 42 years were recruited to the study. All these subjects underwent controlled ovarian stimulation (COS) and later intracytoplasmic sperm injection (ICSI). Subjects were divided into four groups. AMH levels in positive and negative pregnancy subjects in the above and below 35years age groups were compared. AMH levels were correlated with other ovarian reserve parameters and clinical pregnancy out come in both the age groups. Statistically significant differences were found in AMH levels between positive and negative pregnancy subjects in the age group of 35 and above, but not in the age group below 35 years. There were positive correlations between AMH and other ovarian reserve markers and clinical pregnancy outcome in this age group. AMH and the number of retrieved oocytes (r=0.784, P<0.01), Antral Follicle count (AFC) (r=0.749, P<0.01) and Mature Oocytes (MII) (r=0.407, P<0.01) followed by Grade-I Embryos (r=0.433, P<0.01). The current study revealed that AMH levels are better correlated with ovarian reserve and clinical pregnancy out come in subjects aged 35 years and above.

Analysis of anti-Müllerian hormone (AMH) and its receptor (AMHR2) genes in patients with persistent Müllerian duct syndrome / Pesquisa de mutações nos genes do hormônio antiMülleriano (AMH) e do seu receptor (AMHR2) em pacientes com síndrome de persistência dos ductos Müllerianos

OBJECTIVE: To screen for mutations in AMH and AMHR2 genes in patients with persistent Müllerian duct syndrome (PMDS). PATIENTS AND METHOD: Genomic DNA of eight patients with PMDS was obtained from peripheral blood leukocytes. Directed sequencing of the coding regions and the exon-intron boundaries of AMH and AMHR2 were performed. RESULTS: The AMH mutations p.Arg95*, p.Arg123Trp, c.556-2A>G, and p.Arg502Leu were identified in five patients; and p.Gly323Ser and p.Arg407* in AMHR2 of two individuals. In silico analyses of the novel c.556-2A>G, p.Arg502Leu and p.Arg407* mutations predicted that they were harmful and were possible causes of the disease. CONCLUSION: A likely molecular etiology was found in the eight evaluated patients with PMDS. Four mutations in AMH and two in AMHR2 were identified. Three of them are novel mutations, c.556-2A>G, and p.Arg502Leu in AMH; and p.Gly323Ser in AMHR2. Arq Bras Endocrinol Metab. 2012;56(8):473-8.

OBJETIVO: Analisar os genes AMH e AMHR2 em indivíduos com síndrome de persistência dos ductos de Müller (SPDM). PACIENTES E MÉTODO: Amostras de DNA genômico de oito pacientes com SPDM foram obtidas de leucócitos de sangue periférico. Sequenciamento direto da região codificadora e das áreas intrônicas próximas aos éxons dos genes AMH e AMHR foi realizado. RESULTADOS: As mutações p.Arg95*, p.Arg123Trp, c.556-2A>G e p.Arg502Leu no gene AMH foram identificadas em cinco pacientes e as mutações p.Gly323Ser e p.Arg407* no gene AMHR2, em dois indivíduos. As análises in silico das mutações c.556-2A>G, p.Arg502Leu e p.Arg407*, não descritas anteriormente na literatura, previram que elas são deletérias e possivelmente a causa da doença. CONCLUSÃO: Uma provável etiologia molecular foi encontrada nos oito pacientes portadores de SPDM avaliados. No gene do AMH foram identificadas quatro mutações e no AMHR2, duas mutações. Três das seis mutações encontradas são mutações novas, c.556-2A>G e p.Arg502Leu no gene AMH; e p.Gly323Ser no AMHR2. Arq Bras Endocrinol Metab. 2012;56(8):473-8.